A K Gupta1,2, J L Carviel2, W Abramovits3,4,5. 1. Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada. 2. Mediprobe Research Inc., London, Ontario, Canada. 3. Department of Medicine, Baylor University Medical Center, Dallas, TX, USA. 4. Departments of Dermatology and Family Practice, University of Texas Southwestern Medical School, Dallas, TX, USA. 5. Dermatology Treatment and Research Center, Dallas, TX, USA.
Abstract
BACKGROUND: Autoimmune-triggered non-scarring hair loss is a feature of alopecia areata (AA). Initially patchy and often self-limited, severe hair loss forms include the complete loss of scalp hair or alopecia totalis (AT) and complete loss of all hair or alopecia universalis (AU). For AT and AU a reliable treatment has remained elusive. The targeted kinase inhibitor tofacitinib, in current use for treatment of other immune diseases, has been hypothesized as a viable option for AA, AT and AU therapy and a few case reports support this. OBJECTIVE: Our study aims to provide evidence for the effectiveness of tofacitinib in the treatment of AU. METHODS: Two patients diagnosed with long-term AU were prescribed tofacitinib citrate at a dosage of 5 mg twice daily and observed for eight months. RESULTS: In the first patient, beard growth was significant by 3 months of treatment. By 6 months of treatment, hair growth was apparent throughout the entire body. By 8 months of treatment, scalp hair continued to grow longer and thicker. In addition, eyelashes and eyebrows were established. In the second patient, a noticeable increase in scalp hair was present just 1 month into treatment. By 4 months into treatment, significant scalp regrowth was observed as well as eyelash, eyebrow and beard regrowth. Axillary hair regrowth and isolated leg hair was noted by 8 months. CONCLUSION: In our patients, tofacitinib successfully alleviated AU in the absence of significant adverse side-effects. We recommend that further study be required to establish safety and confirm efficacy.
BACKGROUND: Autoimmune-triggered non-scarring hair loss is a feature of alopecia areata (AA). Initially patchy and often self-limited, severe hair loss forms include the complete loss of scalp hair or alopecia totalis (AT) and complete loss of all hair or alopecia universalis (AU). For AT and AU a reliable treatment has remained elusive. The targeted kinase inhibitor tofacitinib, in current use for treatment of other immune diseases, has been hypothesized as a viable option for AA, AT and AU therapy and a few case reports support this. OBJECTIVE: Our study aims to provide evidence for the effectiveness of tofacitinib in the treatment of AU. METHODS: Two patients diagnosed with long-term AU were prescribed tofacitinib citrate at a dosage of 5 mg twice daily and observed for eight months. RESULTS: In the first patient, beard growth was significant by 3 months of treatment. By 6 months of treatment, hair growth was apparent throughout the entire body. By 8 months of treatment, scalp hair continued to grow longer and thicker. In addition, eyelashes and eyebrows were established. In the second patient, a noticeable increase in scalp hair was present just 1 month into treatment. By 4 months into treatment, significant scalp regrowth was observed as well as eyelash, eyebrow and beard regrowth. Axillary hair regrowth and isolated leg hair was noted by 8 months. CONCLUSION: In our patients, tofacitinib successfully alleviated AU in the absence of significant adverse side-effects. We recommend that further study be required to establish safety and confirm efficacy.
Authors: C Herbert Pratt; Lloyd E King; Andrew G Messenger; Angela M Christiano; John P Sundberg Journal: Nat Rev Dis Primers Date: 2017-03-16 Impact factor: 52.329
Authors: Ana M Montilla; Francisco Gómez-García; Pedro J Gómez-Arias; Jesús Gay-Mimbrera; Jorge Hernández-Parada; Beatriz Isla-Tejera; Juan Ruano Journal: Dermatol Ther (Heidelb) Date: 2019-10-13
Authors: Aditya K Gupta; Jessie L Carviel; Kelly A Foley; Neil H Shear; Bianca Maria Piraccini; Vincent Piguet; Antonella Tosti Journal: Skin Appendage Disord Date: 2019-08-29